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Just a penile nodule...

Enes Hajdarbegovic¹, Eric M van der Snoek, Jacobus M Ossewaarde

¹Department of Dermatology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands. e.hajdarbegovic@erasmusmc.nl

Sexually Transmitted Diseases

|February 11, 2010

Summary

A painless penile nodule in an HIV-positive man was diagnosed as lymphogranuloma venereum. This rare sexually transmitted infection, caused by Chlamydia trachomatis, was confirmed by DNA testing after standard screenings failed.

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Area of Science:

Infectious Diseases
Dermatology
Urology

Background:

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by specific serovars of Chlamydia trachomatis.
LGV can present with varied symptoms, often including genital ulcers or lymphadenopathy, and may be mistaken for other conditions.
Early and accurate diagnosis is crucial for effective treatment and preventing complications.

Observation:

A case of a homosexual, HIV-positive male presenting with a painless penile nodule is described.
Initial screening for common sexually transmitted diseases (STDs) did not identify an infection.
The nodule perforated spontaneously, leading to further investigation.

Findings:

DNA from Chlamydia trachomatis serovar L2 was extracted from the penile lesion.
A definitive diagnosis of lymphogranuloma venereum was established based on molecular detection.
This case highlights the limitations of standard STD screening protocols in diagnosing LGV.

Implications:

Standard STD screening may be insufficient for diagnosing lymphogranuloma venereum, particularly in atypical presentations.
Clinicians should maintain a high index of suspicion for LGV in patients with unexplained genital lesions, especially those with risk factors.
Enhanced diagnostic approaches, including molecular testing, may be necessary for timely LGV diagnosis and management.